• Title/Summary/Keyword: CTA 영상

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Contrast-Enhanced Magnetic Resonance Angiography for Evaluation of the Steno-occlusive Disease of the Supraaortic Arteries: Comparison with Computed Tomography Angiography and Digital Subtraction Angiography (조영증강 자기공명 혈관조영술을 이용한 대동맥궁 위 혈관의 협착 및 페쇄 질환 평가: 전산화 단층 혈관조영술 및 디지털 감산혈관조영술과의 비교)

  • Jeh, Su-Kyung;Kim, Bum-Soo;Jung, So-Lyung;Ahn, Kook-Jin;Shin, Yong-Sam;Lee, Kwan-Sung;Kim, Young-In;Lee, Kwang-Soo
    • Investigative Magnetic Resonance Imaging
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    • v.13 no.2
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    • pp.152-160
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    • 2009
  • Purpose : To intra-individually compare diagnostic accuracy of high-resolution contrast-enhanced magnetic resonance angiography (CE-MRA) with computed tomography angiography (CTA) and digital subtraction angiography (DSA) for the assessment of supraaortic steno-occlusive disease. Materials and Methods : Twenty-eight patients (20 men, 8 women, 53-79 years of age) underwent supraaortic CE-MRA, CTA and DSA. CE-MRA was performed on two 1.5T MR scanners (voxel dimension: $0.66{\times}0.66{\times}1.1$ or $1.2\;mm^3$), and CTA on 64-slice CT scanners (voxel dimension: $0.42{\times}0.42{\times}0.63\;mm^3$). All the three examinations were completed within 40 days (median 19 days; range 1-40 days). Retrospective evaluation and measurement of diameter of 6 extracranial and 9 intracranial arterial segments was done by 2 experienced radiologists. Results: A total of 420 arterial segments were examined by CE-MRA, CTA and DSA. On DSA, 34 stenoocclusive lesions were noted at extracranial (n= 19) and intracranial (n = 15) vessels. For extracranial stenosis greater than 70%, sensitivity, specificity, positive predictive value (PPV) and negative predictive values (NPV) were 94.7%, 98.7%, 90.0% and 99.3% on CE-MRA, and 94.7%, 99.3%, 94.7% and 99.3% on CTA. For intracranial stenosis greater than 50%, sensitivity; specificity, PPV and NPV were 93.3%, 98.3%, 77.8%and 99.6% on CE-MRA, and 86.7%, 97.9%, 72.2% and 99.1 % on CTA, with DSA as the standard of reference. Conclusion : Supraaortic CE-MRA is as reliable as CTA in depicting the arterial stenosis, and is effective in screening of significant stenosis of both extracranial and intracranial arterial stenosis.

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Added Value of 3D Cardiac SPECT/CTA Fusion Imaging in Patients with Reversible Perfusion Defect on Myocardial Perfusion SPECT (심근관류 SPECT에서 가역적인 병변을 보인 환자의 3차원 심장 SPECT/CTA 퓨전영상의 유용성)

  • Kong, Eun-Jung;Cho, Ihn-Ho;Kang, Won-Jun;Kim, Seong-Min;Won, Kyoung-Sook;Lim, Seok-Tae;Hwang, Kyung-Hoon;Lee, Byeong-Il;Bom, Hee-Seung
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.6
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    • pp.513-518
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    • 2009
  • Purpose: Integration of the functional information of myocardial perfusion SPECT (MPS) and the morphoanatomical information of coronary CT angiography (CTA) may provide useful additional diagnostic information of the spatial relationship between perfusion defects and coronary stenosis. We studied to know the added value of three dimensional cardiac SPECT/CTA fusion imaging (fusion image) by comparing between fusion image and MPS. Materials and Methods: Forty-eight patients (M:F=26:22, Age: $63.3{\pm}10.4$ years) with a reversible perfusion defect on MPS (adenosine stress/rest SPECT with Tc-99m sestamibi or tetrofosmin) and CTA were included. Fusion images were molded and compared with the findings from the MPS. Invasive coronary angiography served as a reference standard for fusion image and MPS. Results: Total 144 coronary arteries in 48 patients were analyzed; Fusion image yielded the sensitivity, specificity, negative and positive predictive value for the detection of hemodynamically significant stenosis per coronary artery 82.5%, 79.3%, 76.7% and 84.6%, respectively. Respective values for the MPS were 68.8%, 70.7%, 62.1% and 76.4%. And fusion image also could detect more multi-vessel disease. Conclusion: Fused three dimensional volume-rendered SPECT/CTA imaging provides intuitive convincing information about hemodynamic relevant lesion and could improved diagnostic accuracy.

An Estimate of Image Quality and Radiation Doses of Coronary Artery in MDCT Using Prospective and Retrospective ECG Gating Scan Mode (MDCT 관상동맥 조영 검사에서 전향적 동조화 및 후향적 동조화 기법의 화질과 선량 관계)

  • Oh, Jong-Kap
    • Journal of radiological science and technology
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    • v.34 no.4
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    • pp.315-321
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    • 2011
  • The goal of this study is to reduce patient exposure dose by providing image quality and radiation dose according to inspection methods. Volume Computed Tomography Dose Index(CTDIvol) and Dose Length Product(DLP) of prospective and retrospective ECG gating snapshot segment of Coronary CT angiography(CTA) were measured each snapshot segment methods. CT number, noise, uniformity, and resolution were also measured using phantom under the same condition of coronary CTA. The results showed that CT number, noise, uniformity and resolution are similar to each other. In terms of CTDIvol and DLP, however, measurement dose of prospective ECG gating snapshot segment was lower than the retrospective case by 37.5% and 40.3%. Therefore, it is highly recommended that in the coronary CTA, prospective ECG gating scan mode should be chosen to reduce patient dose.

The Clinical Usefulness Evaluation of Normal Saline Injection in Coronary Artery Computed Tomography Angiography(Coronary CTA) (관상동맥 전산화단층촬영 조영검사에서 생리식염수 투여를 통한 임상 유용성 평가)

  • Jung, Kang-Kyo;Lee, Mi-Hwa;Cho, Pyong-Kon
    • Journal of radiological science and technology
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    • v.37 no.4
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    • pp.307-313
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    • 2014
  • The purpose of this study is that in coronary artery angiography computed tomography (coronary CTA), to gain high quality of image and to use low dose radiation by administrating normal saline and converting the mode of scanning heart rate (HR) characteristics before infusing contrast media. All patients data (total specimens: 200, male: 108, female: 92) were measured by using appropriate mode of scanning the heart rate (HR) after injection of saline. in addition we measured radiation dose (CTDIvol, effective dose) in all examinations. CT number and noise, and blurring of coronary artery (proximal RCA, middle RCA, proximal LCA) were measured and compared. The result of this study after injection of saline, mean heart rate was decreased about $4.8{\pm}0.3bpm$ (beats per minute). 33 patients (13%) got converting scan mode due to reducing heart rate (HR). In prospective gating mode, radiation dose were measured less $6.0{\pm}1.0mSv$ (54.1%) than retrospective gating mode. Also showed a significant difference in heart rate decrease in image evaluation.

The Usefulness of Multidetector CT Arthrography in the Diagnosis of Shoulder Pathology -Comparison with MR Arthrography and Arthroscopic Findings in the Same Patient- (견관절 병변의 진단에서 다중 검출 전산화 단층촬영을 이용한 관절조영술의 유용성 - 동일 환자에서 시행한 자기공명 관절조영술 및 관절경 소견과의 비교 -)

  • Kim, Dong-Soo;Park, Kyoung-Jin;Kim, Yong-Min;Choi, Eui-Sung;Shon, Hyun-Chul;Cho, Byung-Ki;Park, Ji-Kang;Kim, Seok-Won
    • Clinics in Shoulder and Elbow
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    • v.12 no.2
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    • pp.115-125
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    • 2009
  • Purpose: The purpose of the study is to evaluate the usefulness of CT arthrography (CTA) by conducting a comparative study of CTA and MR arthrography (MRA) with the arthroscopic findings in the same patients. Materials and methods: Forty nine patients who suffered from shoulder disease underwent MRA and CTA concurrently. The sensitivity and specificity of CTA was evaluated, as compared to MRA, in the case of four types of shoulder pathological lesions. The accuracy of CTA was evaluated by analyzing the arthroscopic findings of thirty four patients. Results: Compared to MRA, CTA showed a sensitivity of 90% and a specificity of 100% for diagnosing supraspinatus tendon (SST) full thickness tear, and CTA showed a sensitivity of 100% and a specificity of 97.5% for making the diagnosis of superior labrum anterior to posterior (SLAP) lesion. For diagnosing partial articular side supraspinatus avulsion (PASTA) lesion, some studies have shown the usefulness of CTA with a sensitivity of 71.4% and a specificity of 97.7%. However, for diagnosing SST bursal side partial tear, the sensitivity of CTA was as low as 10%. CTA has been shown to be relatively accurate when the diagnoses were verified with the arthroscopic findings; diagnosing SST full thickness tear and SLAP lesion with CTA has shown an accuracy of 100% and87.5% respectively, and CTA showed 71.4% diagnostic accuracy for PASTA lesion. Conclusion: CTA was a useful tool and it was equivalent to MRA for the assessment of SST full thickness tear, SLAP lesion and PASTA lesion, but not bursal side partial tear. Thus, it may be used preferably to diagnose shoulder pathology and for follow up as an inexpensive tool after operation.

Characterization of Deep Learning-Based and Hybrid Iterative Reconstruction for Image Quality Optimization at Computer Tomography Angiography (전산화단층촬영조영술에서 화질 최적화를 위한 딥러닝 기반 및 하이브리드 반복 재구성의 특성분석)

  • Pil-Hyun, Jeon;Chang-Lae, Lee
    • Journal of the Korean Society of Radiology
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    • v.17 no.1
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    • pp.1-9
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    • 2023
  • For optimal image quality of computer tomography angiography (CTA), different iodine concentrations and scan parameters were applied to quantitatively evaluate the image quality characteristics of filtered back projection (FBP), hybrid-iterative reconstruction (hybrid-IR), and deep learning reconstruction (DLR). A 320-row-detector CT scanner scanned a phantom with various iodine concentrations (1.2, 2.9, 4.9, 6.9, 10.4, 14.3, 18.4, and 25.9 mg/mL) located at the edge of a cylindrical water phantom with a diameter of 19 cm. Data obtained using each reconstruction technique was analyzed through noise, coefficient of variation (COV), and root mean square error (RMSE). As the iodine concentration increased, the CT number value increased, but the noise change did not show any special characteristics. COV decreased with increasing iodine concentration for FBP, adaptive iterative dose reduction (AIDR) 3D, and advanced intelligent clear-IQ engine (AiCE) at various tube voltages and tube currents. In addition, when the iodine concentration was low, there was a slight difference in COV between the reconstitution techniques, but there was little difference as the iodine concentration increased. AiCE showed the characteristic that RMSE decreased as the iodine concentration increased but rather increased after a specific concentration (4.9 mg/mL). Therefore, the user will have to consider the characteristics of scan parameters such as tube current and tube voltage as well as iodine concentration according to the reconstruction technique for optimal CTA image acquisition.

Coronary Computed Tomography Angiography for the Diagnosis of Vasospastic Angina: Comparison with Invasive Coronary Angiography and Ergonovine Provocation Test

  • Jiesuck Park;Hyung-Kwan Kim;Eun-Ah Park;Jun-Bean Park;Seung-Pyo Lee;Whal Lee;Yong-Jin Kim;Dae-Won Sohn
    • Korean Journal of Radiology
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    • v.20 no.5
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    • pp.719-728
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    • 2019
  • Objective: To investigate the diagnostic validity of coronary computed tomography angiography (cCTA) in vasospastic angina (VA) and factors associated with discrepant results between invasive coronary angiography with the ergonovine provocation test (iCAG-EPT) and cCTA. Materials and Methods: Of the 1397 patients diagnosed with VA from 2006 to 2016, 33 patients (75 lesions) with available cCTA data from within 6 months before iCAG-EPT were included. The severity of spasm (% diameter stenosis [%DS]) on iCAGEPT and cCTA was assessed, and the difference in %DS (Δ%DS) was calculated. Δ%DS was compared after classifying the lesions according to pre-cCTA-administered sublingual nitroglycerin (SL-NG) or beta-blockers. The lesions were further categorized with %DS ≥ 50% on iCAG-EPT or cCTA defined as a significant spasm, and the diagnostic performance of cCTA on identifying significant spasm relative to iCAG-EPT was assessed. Results: Compared to lesions without SL-NG treatment, those with SL-NG treatment showed a higher Δ%DS (39.2% vs. 22.1%, p = 0.002). However, there was no difference in Δ%DS with or without beta-blocker treatment (35.1% vs. 32.6%, p = 0.643). The significant difference in Δ%DS associated with SL-NG was more prominent in patients who were aged < 60 years, were male, had body mass index < 25 kg/m2, and had no history of hypertension, diabetes, or dyslipidemia. Based on iCAG-EPT as the reference, the per-lesion-based sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of cCTA for VA diagnosis were 7.5%, 94.0%, 60.0%, 47.1%, and 48.0%, respectively. Conclusion: For patients with clinically suspected VA, confirmation with iCAG-EPT needs to be considered without completely excluding the diagnosis of VA simply based on cCTA results, although further prospective studies are required for confirmation.

Automatic Extraction of Ascending Aorta and Ostium in Cardiac CT Angiography Images (심장 CT 혈관 조영 영상에서 대동맥 및 심문 자동 검출)

  • Kim, Hye-Ryun;Kang, Mi-Sun;Kim, Myoung-Hee
    • Journal of the Korea Computer Graphics Society
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    • v.23 no.1
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    • pp.49-55
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    • 2017
  • Computed tomographic angiography (CTA) is widely used in the diagnosis and treatment of coronary artery disease because it shows not only the whole anatomical structure of the cardiovascular three-dimensionally but also provides information on the lesion and type of plaque. However, due to the large size of the image, there is a limitation in manually extracting coronary arteries, and related researches are performed to automatically extract coronary arteries accurately. As the coronary artery originate from the ascending aorta, the ascending aorta and ostium should be detected to extract the coronary tree accurately. In this paper, we propose an automatic segmentation for the ostium as a starting structure of coronary artery in CTA. First, the region of the ascending aorta is initially detected by using Hough circle transform based on the relative position and size of the ascending aorta. Second, the volume of interest is defined to reduce the search range based on the initial area. Third, the refined ascending aorta is segmented by using a two-dimensional geodesic active contour. Finally, the two ostia are detected within the region of the refined ascending aorta. For the evaluation of our method, we measured the Euclidean distance between the result and the ground truths annotated manually by medical experts in 20 CTA images. The experimental results showed that the ostia were accurately detected.

Usefulness of 3D Rotational Angiography for Cerebral Vascular Diameter Measurement (뇌혈관 직경측정을 위한 3차원 회전 혈관조영술의 유용성)

  • Seung-Gi, Kim;Sang-Hyun, Kim
    • Journal of radiological science and technology
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    • v.46 no.1
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    • pp.9-14
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    • 2023
  • When measuring cerebrovascular with 3D rotational angiography, the accuracy was verified by comparing the actual size and measurement size, respectively. It is intended to help select therapeutic materials and instruments during cerebrovascular intervention by comparing the average error rates for measured values in the 3DRA and CTA methods by examining with protocols such as brain CTA, which are always performed in emergency situations. The mean error rate between the groups of measurers was ±3.655% for radiation technologist and ±3.331% for university students, and the mean error rate of the student group was within tolerance (±10%), and the independent sample T-test result t =0.879, p=0.394 (p>0.05) showed no statistically difference between the two. In addition, the average error rate measured by both groups by 3DRA was measured below ±5% within the tolerance error rate (±10%), and most of CTA was measured within the tolerance range (±10%), but showed an average error rate of up to 5.65%, and the independent sample T-test result was statistically more accurate than 3DRA. Both the 3DRA method and the brain CTA method for measuring cerebrovascular size could be accurately measured within tolerance, but it would be better to measure cerebrovascular blood vessels using a more accurate 3DRA method during cerebrovascular intervention.