Triple-split-bolus versus single-bolus CT in abdominal trauma patients: a comparative study

2018 ◽  
Vol 59 (9) ◽  
pp. 1038-1044 ◽  
Author(s):  
Johannes Clemens Godt ◽  
Torsten Eken ◽  
Anselm Schulz ◽  
Cathrine K Johansen ◽  
Anette Aarsnes ◽  
...  
Keyword(s):  
Image Quality ◽  
Renal Pelvis ◽  
Organ Injury ◽  
Trauma Patients ◽  
Arterial Tree ◽  
Portal Venous Phase ◽  
Abdominal Organs ◽  
Ct Protocol ◽  
Venous Phase ◽  
Contrast Bolus

Background Split-bolus computed tomography (CT) is a recent development in trauma imaging. Instead of multiple scans in different contrast phases after a single contrast bolus, split-bolus protocols consist of one single scan of the thorax and abdomen after two or three contrast injections at different points of time. Purpose To evaluate and compare image quality and injury findings of a new triple-split-bolus CT (TS-CT) protocol of thorax and abdomen with those of a portal venous phase CT (PV-CT) in the same patient group. Material and Methods Trauma patients in 2009–2012 who underwent both the TS-CT initially and a PV-CT during the next six weeks were included. The TS-CT examination was performed as one CT run after application of three contrast boluses (total 175 mL) to enhance renal pelvis and urinary tract, the abdominal organs, and the large arterial vessels. The PV-CT had a fixed delay of 85 s. We measured attenuation in Hounsfield units (HU), evaluated possible organ injury and assessed image quality on a 5-point scale. Results Thirty-five patients were included. Attenuation measurements of major abdominal vessels, organs, and renal pelvis were significantly higher with the TS-CT protocol. Performance in organ injury diagnosis and image quality was equal in both protocols. Conclusion The overall performance of the TS-CT protocol is similar to the standard PV-CT. Excellent visualization of the arterial tree and the collecting system may eliminate the need for separate scans.

Split-Bolus Portal Venous Phase Dual-Energy CT Urography: Protocol Design, Image Quality, and Dose Reduction

2015 ◽  
Vol 205 (5) ◽  
pp. W492-W501 ◽  
Author(s):  
Chiao-Yun Chen ◽  
Jui-Sheng Hsu ◽  
Twei-Shiun Jaw ◽  
Ming-Chen Paul Shih ◽  
Lo-Jeh Lee ◽  
...  
Keyword(s):  
Image Quality ◽  
Dose Reduction ◽  
Dual Energy ◽  
Protocol Design ◽  
Dual Energy Ct ◽  
Ct Urography ◽  
Portal Venous Phase ◽  
Venous Phase

Injuries to the Spleen and Diaphragm

2020 ◽  
Author(s):  
Andrea M. Long ◽  
Preston R Miller ◽  
J. Jason Hoth
Keyword(s):  
Motor Vehicle ◽  
Gunshot Wounds ◽  
Organ Injury ◽  
Trauma Patients ◽  
Left Hemithorax ◽  
Stab Wounds ◽  
Computed Tomographic ◽  
Abdominal Organs ◽  
Left Diaphragm ◽  
Liver Injuries

The spleen is one of the most commonly injured abdominal organs in blunt trauma patients. The mechanisms of injury are similar to those seen with liver injuries: motor vehicle collisions, automobile-pedestrian collisions, falls, and any type of penetrating injury. Stab wounds to the abdomen are less likely to cause spleen injury compared with liver injury due to the spleen’s protected location. Stab wounds to the spleen typically result in direct linear tears, whereas gunshot wounds result in significant cavitary injuries. This review covers injuries to the spleen and injuries to the diaphragm. Figures show findings on imaging that may be associated with failure of nonoperative management for splenic injuries, intraparenchymal splenic blush noted on an initial computed tomographic scan, the first step in mobilizing the spleen by making an incision in the peritoneum and the endoabdominal fascia, beginning at the inferior pole and continuing posteriorly and superiorly, splenorrhaphy performed using interrupted mattress sutures through pledgets along the raw edge of the spleen, left diaphragm ruptures evident with the gastric bubble located in the left hemithorax, whereas right-sided ruptures present with the appearance of an elevated hemidiaphragm, and the use of Allis clamps to approximate the diaphragmatic edges, with the defect closed with a running No. 1 polypropylene suture. The table lists American Association for the Surgery of Trauma organ injury scales for diaphragm and spleen. This review contains 6 figures, 1 table, and 55 references Keywords: spleen, injury grading, angioembolization, splenorrhaphy, splenic salvage

scholarly journals Portal Venous-Phase CT of the Liver in Patients without Chronic Liver Damage: Does Portal-Inflow Tracking Improve Enhancement and Image Quality?

2013 ◽  
Vol 03 (03) ◽  
pp. 112-116
Author(s):  
Masayuki Kanematsu ◽  
Haruo Watanabe ◽  
Hiroshi Kondo ◽  
Satoshi Goshima ◽  
Hiroshi Kawada ◽  
...  
Keyword(s):  
Image Quality ◽  
Liver Damage ◽  
Chronic Liver ◽  
Chronic Liver Damage ◽  
Portal Venous Phase ◽  
Venous Phase

scholarly journals Optimizing Trauma Multidetector CT Protocol for Blunt Splenic Injury: Need for Arterial and Portal Venous Phase Scans

Radiology ◽  
2013 ◽  
Vol 268 (1) ◽  
pp. 79-88 ◽  
Author(s):  
Alexis R. Boscak ◽  
Kathirkamanathan Shanmuganathan ◽  
Stuart E. Mirvis ◽  
Thorsten R. Fleiter ◽  
Lisa A. Miller ◽  
...  
Keyword(s):  
Splenic Injury ◽  
Multidetector Ct ◽  
Blunt Splenic Injury ◽  
Portal Venous Phase ◽  
Ct Protocol ◽  
Venous Phase

scholarly journals Impact of novel deep learning image reconstruction algorithm on diagnosis of contrast-enhanced liver computed tomography imaging: Comparing to adaptive statistical iterative reconstruction algorithm

2021 ◽  
pp. 1-10
Author(s):  
Shuo Yang ◽  
Yifan Bie ◽  
Guodong Pang ◽  
Xingchao Li ◽  
Kun Zhao ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Image Quality ◽  
Detection Rate ◽  
Reconstruction Algorithm ◽  
Lesion Detection ◽  
Adaptive Statistical Iterative Reconstruction ◽  
Portal Venous Phase ◽  
Statistical Iterative Reconstruction ◽  
Contrast Enhanced ◽  
Venous Phase

OBJECTIVE: To assess clinical application of applying deep learning image reconstruction (DLIR) algorithm to contrast-enhanced portal venous phase liver computed tomography (CT) for improving image quality and lesions detection rate compared with using adaptive statistical iterative reconstruction (ASIR-V) algorithm under routine dose. METHODS: The raw data from 42 consecutive patients who underwent contrast-enhanced portal venous phase liver CT were reconstructed using three strength levels of DLIRs (low [DL-L]; medium [DL-M]; high [DL-H]) and two levels of ASIR-V (30%[AV-30]; 70%[AV-70]). Objective image parameters, including noise, signal-to-noise (SNR), and the contrast-to-noise ratio (CNR) relative to muscle, as well as subjective parameters, including noise, artifact, hepatic vein-clarity, index lesion-clarity, and overall scores were compared pairwise. For the lesions detection rate, the five reconstructions in patients who underwent subsequent contrast-enhanced magnetic resonance imaging (MRI) examinations were compared. RESULTS: For objective parameters, DL-H exhibited superior image quality of lower noise and higher SNR than AV-30 and AV-70 (all P <  0.05). CNR was not statistically different between AV-70, DL-M, and DL-H (all P >  0.05). In both objective and subjective parameters, only image noise was statistically reduced as the strength of DLIR increased compared with ASIR-V (all P <  0.05). Regarding the lesions detection rate, a total of 45 lesions were detected by MRI examination and all five reconstructions exhibited similar lesion-detection rate (25/45, 55.6%). CONCLUSION: Compared with AV-30 and AV 70, DLIR leads to better image quality with equal lesion detection rate for liver CT imaging under routine dose.

Rapid kVp-switching DECT portal venous phase abdominal CT scans in patients with large body habitus: image quality considerations

2020 ◽  
Vol 45 (9) ◽  
pp. 2902-2909
Author(s):  
Vinit Baliyan ◽  
Hamed Kordbacheh ◽  
Ali Pourvaziri ◽  
Jessica Serrao ◽  
Evita Joseph ◽  
...  
Keyword(s):  
Image Quality ◽  
Large Body ◽  
Ct Scans ◽  
Abdominal Ct ◽  
Body Habitus ◽  
Portal Venous Phase ◽  
Venous Phase
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