Dual-layer detector CT of the head: Initial experience in visualization of intracranial hemorrhage and hypodense brain lesions using virtual monoenergetic images

This study details the type, frequency, clinical presentation, and etiologic associations of acquired brain lesions in 40 infants with the hypoplastic left heart syndrome encountered during a 52-month interval. Detailed postmortem neuropathologic examinations showed that 55% of the infants were free of acquired brain lesions. However, the other 45% had combinations of hypoxic-ischemic lesions and intracranial hemorrhage. Central nervous system perfusion and glucose-oxygen delivery appeared to be important factors in the occurrence of hypoxic-ischemic lesions or intracranial hemorrhage, whereas acidosis and hypercarbia were not. Cerebral necrosis may be a predisposing factor for a major intracranial hemorrhage. A duration of cardiopulmonary bypass with hypothermic total circulatory arrest longer than 40 minutes was associated with a higher incidence of acquired neuropathology. These results indicate that the majority of infants with hypoplastic left heart syndorme are free of acquired neuropathology and suggest practical ways to reduce the risks in the others.

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Etiology and Pathogenesis of Intraventricular Hemorrhage in Newborns

PEDIATRICS ◽

10.1542/peds.84.2.382 ◽

1989 ◽

Vol 84 (2) ◽

pp. 382-385

Author(s):

KAREN E. PAPE

Keyword(s):

Intracranial Hemorrhage ◽

Intraventricular Hemorrhage ◽

Ct Scanning ◽

Postmortem Examination ◽

Brain Lesions ◽

Ct Scans ◽

Clinical Criteria ◽

The Status

The article by Miall-Allen et al is an important contribution to the status of BP control and intracranial hemorrhage in the newborn. Until 10 years ago, there were limited methods of assessment. Hemorrhagic brain lesions were diagnosed mainly by clinical criteria and postmortem examination. In the late 1970s, CT scans provided much more in vivo information. However, CT scanning is inherently difficult in the newborn. Early machines produced a significant amount of radiation and the infants had to be transported to a radiology unit. These difficulties meant that a limited number of scans were done and children were rarely sequentially exposed.

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Utility of virtual monoenergetic images derived from a dual-layer detector-based spectral CT in the assessment of aortic anatomy and pathology: A retrospective case control study

Clinical Imaging ◽

10.1016/j.clinimag.2018.08.007 ◽

2018 ◽

Vol 52 ◽

pp. 292-301 ◽

Cited By ~ 9

Author(s):

Hamid Chalian ◽

Kevin Kalisz ◽

Negin Rassouli ◽

Amar Dhanantwari ◽

Prabhakar Rajiah

Keyword(s):

Case Control Study ◽

Case Control ◽

Spectral Ct ◽

Retrospective Case ◽

Virtual Monoenergetic Images ◽

Control Study ◽

Monoenergetic Images

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Image quality characteristics for virtual monoenergetic images using dual-layer spectral detector CT: Comparison with conventional tube-voltage images

Physica Medica ◽

10.1016/j.ejmp.2018.04.388 ◽

2018 ◽

Vol 49 ◽

pp. 5-10 ◽

Cited By ~ 8

Author(s):

Daisuke Sakabe ◽

Yoshinori Funama ◽

Katsuyuki Taguchi ◽

Takeshi Nakaura ◽

Daisuke Utsunomiya ◽

...

Keyword(s):

Image Quality ◽

Quality Characteristics ◽

Tube Voltage ◽

Spectral Detector Ct ◽

Virtual Monoenergetic Images ◽

Monoenergetic Images

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Role of spectral-detector CT in reduction of artifacts from contrast media in axillary and subclavian veins: single institution study in 50 patients

Acta Radiologica ◽

10.1177/0284185119868904 ◽

2019 ◽

Vol 61 (4) ◽

pp. 450-460 ◽

Cited By ~ 3

Author(s):

Kai Roman Laukamp ◽

Amit Gupta ◽

Nils Große Hokamp ◽

Verena Carola Obmann ◽

Frank Philipp Graner ◽

...

Keyword(s):

Soft Tissue ◽

Contrast Media ◽

Intraclass Correlation ◽

Ct Images ◽

Diagnostic Assessment ◽

Surrounding Soft Tissue ◽

Iodinated Contrast ◽

Spectral Detector Ct ◽

Virtual Monoenergetic Images ◽

Monoenergetic Images

Background In CT imaging, a high concentration of iodinated contrast media in axillary and subclavian veins after brachial application can cause perivenous artifacts impairing diagnostic assessment of local vascular structures and soft tissue. Purpose To investigate reduction of perivenous hypo- and hyperattenuating artifacts of the axillary and subclavian veins using virtual monoenergetic images (VMI) in comparison to conventional CT images (CI), acquired on spectral-detector CT. Material and Methods 50 spectral-detector CT datasets of patients with perivenous artifacts from contrast media were included in this retrospective, institutional review board-approved study. CT images and virtual monoenergetic images (range 40–200 keV, 10-keV increments) were reconstructed from the same scans. Quantitative analysis was performed by region of interest-based assessment of mean attenuation (HU) and standard deviation in most pronounced hypo- and hyperdense artifacts and artifact-impaired arteries as well as muscle. Visually, artifact reduction, assessment of vessels, and surrounding soft tissue were rated on 5-point Likert-scales by two radiologists. Results In comparison to CT images, virtual monoenergetic images of ≥90 keV showed a significant reduction of hypo- and hyperattenuating artifacts (hypodense: CI -220.0±171.2 HU; VMI130keV -13.4±49.1 HU; hyperdense: CI 274.6±184.4 HU; VMI130keV 24.2±84.9 HU; P<0.001). Subjective analysis confirmed that virtual-monoenergetic images of ≥100 keV significantly reduced artifacts (hypodense: CI 2[1–3]; VMI130keV 5[4–5], hyperdense: CI 2[1–4]; VMI130keV 5[5–5], P<0.001) and improved diagnostic assessment. Best results for diagnostic assessment were noted for virtual monoenergetic images at 130 keV. Overcorrection of artifacts was observed at higher keV values. Interrater agreement was excellent for each evaluation and keV value (intraclass correlation coefficient 0.89). Conclusion Higher keV virtual monoenergetic images yielded significant reduction of contrast media artifacts and led to improved assessment of vessels and surrounding soft tissue. Recommended keV values for best diagnostic assessment are in the range of 100–160 keV.

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