Bubble study as a medium of contrast for computerized tomography coronary angiography. (Preprint)

2020 ◽  
Author(s):  
Vijay Shah ◽  
Justyn Huang
Keyword(s):  
Pulmonary Artery ◽  
Diagnostic Yield ◽  
Negative Contrast ◽  
Hounsfield Unit ◽  
Hounsfield Units ◽  
Computed Tomographic ◽  
Invasive Test ◽  
Clinical Difference ◽  
Contrast Ct ◽  
Scan Protocol

BACKGROUND Computed tomographic coronary angiogram (CTCA) is a non-invasive test with a negative predictive value of nearly 100% for the detection of coronary artery study. While diagnostic yield of a dedicated CTCA with bubble contrast is not yet evaluated OBJECTIVE To assess the diagnostic performance of injected bubble contrast and ability to measure difference in hounsfield units and use it as a "negative contrast" in computed tomographic METHODS This is a single center, single patient study. Baseline acquisition of a non-contrast CT scan was acquired to get hounsfield unit count in the aorta and pulmonary artery- (Calcium scan protocol) 1.4 mGy (19.5 mGy/cm). Secondly, Echo contrasts (Definity) - 5mls was injected and an echocardiogram confirmed filling in the aortic region. Finally, bubble contrast (1ml air, 8mls water and 1mls blood was drawn up and agitated through a 3 way tap) - was injected, a timing run was initiated to calculate for the bubbles to opacity the pulmonary artery. The same scan protocol was used– 1.4 mGy (19.5 mGy/cm). RESULTS Hounsfield units’ difference in the aorta and pulmonary artery from baseline compared to echo contrast and bubble contrast were not significant. CONCLUSIONS We believe this is the first ever recorded case to use bubbles as CT contrast. While results were not significant, secondary to small volume of bubbles injected. Further research needs to be implemented to assess clinical difference with amount of bubbles and volume required. CLINICALTRIAL Single centre study

scholarly journals Feline injection site sarcoma: computed-tomographic density and assessment of tumor dimensions by different methods

2017 ◽  
Vol 37 (10) ◽  
pp. 1113-1118
Author(s):  
Karen Maciel Zardo ◽  
Lucas Petri Damiani ◽  
Julia Maria Matera ◽  
Ana Carolina B.C. Fonseca-Pinto
Keyword(s):  
Physical Examination ◽  
Injection Site ◽  
Malignant Neoplasm ◽  
Hounsfield Unit ◽  
Ct Images ◽  
Post Contrast ◽  
Computed Tomographic ◽  
Definition Of ◽  
Ct Density ◽  
Contrast Ct

ABSTRACT: Feline injection site sarcoma is a malignant neoplasm with digitiform projections into muscular planes that are ill recognized during physical examination and may compromise tumor margin demarcation. This study compared tumoral size of 32 cats measured by different methods, and evaluated the CT density of 10 tumoral tissues (Hounsfield unit) based on histograms. Tumor axes were measured by physical examination and CT images. Larger craniocaudal axis measurements were obtained following multiplanar reconstruction of pre- and post-contrast CT images (p=0.049 and p=0.041 respectively); dorsoventral axis measurements taken from post-contrast CT images were also larger (p=0.010). Tumor volume estimates increased following contrast-enhancement. Histograms tended to produce two peaks: one in the fat and another in the soft tissue attenuation range. Multiplanar reconstructed post-contrast CT images provided clearer definition of tumor margins and more judicious determination of tumor size. A tendency of common FISS attenuation profile could be described.

Metrizamide Computed Tomographic Cisternography for the Diagnosis of Occult Lesions of the Hypothalamic-Hypophyseal Axis in Children

Neurosurgery ◽  
1981 ◽  
Vol 8 (5) ◽  
pp. 531-541 ◽  
Author(s):  
Dachling Pang ◽  
Arthur E. Rosenbaum ◽  
James E. Wilberger ◽  
James P. Gutai
Keyword(s):  
Computed Tomography ◽  
Diagnostic Yield ◽  
Empty Sella ◽  
Functional Disorders ◽  
Ct Cisternography ◽  
Empty Sella Syndrome ◽  
Computed Tomographic ◽  
Suprasellar Cistern ◽  
Enhanced Computed Tomography ◽  
Metrizamide Ct Cisternography

Abstract In children, hypothalamic-hypophyseal syndromes such as diabetes insipidus, precocious puberty, growth retardation, and panhypopituitarism can be due either to structural lesions or to functional disorders of the cerebral endocrine complex. When clinical and endocrinological parameters fail to distinguish between these etiologies, neuroradiographical diagnosis becomes extremely important. Although conventional intravenously enhanced computed tomography (IVCT) is satisfactory for the diagnosis of lesions larger than 1 cm, metrizamide CT cisternography (MCTC) greatly improves the diagnostic yield for smaller juxtapituitary masses in the suprasellar cistern, clearly defines their sizes and relationships with contiguous structures, and definitively confirms the diagnosis of empty sella syndrome. Six patients with endocrinopathies and normal or ambiguous IVCT findings are presented to illustrate how MCTC can influence their management and outcome without the patient discomfort and technical complexity associated with pneumoencephalography.

Abstract T P10: Hounsfield Unit Value and Clot Length in the Acutely Occlude Vessel and Time Required to Achieve Thrombectomy, Complications and Outcome

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Alejandro Spiotta ◽  
Jan Vargas ◽  
Harris Hawk ◽  
Raymond Turner ◽  
Imran Chaudry ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Functional Outcome ◽  
Hounsfield Unit ◽  
Hounsfield Units ◽  
Unit Value ◽  
Procedural Complications ◽  
Noncontrast Ct ◽  
Time Required

Introduction: Intra-arterial therapy for acute ischemic stroke (AIS) now has an established role. We investigated if Hounsfield Units (HU) quantification on noncontrast CT is associated with ease and efficacy of mechanical thrombectomy and outcomes. Methods: We retrospectively studied a prospectively maintained database of cases of acute ischemic stroke that underwent intra-arterial therapy between May 2008 and August 2012. Functional outcome was assessed by ninety-day follow up modified Rankin Scale (mRS). Patients were dichotomized base on time to recanalization. Hounsfield units were calculated on head CT. Thrombus location and length were determined on CT angiography. Simple linear regression was used to analyze the association between clot length, average HU, and other clinical variables. Results: 141 patients were included. There was no difference in clot length or average HU among patients with good recanalization achieved within an hour compared to those in which procedures extended beyond an hour. There was no relationship between clot length or density and recanalization. The thrombus length and density were not significantly different between patients with procedural complications and those without. The presence of post procedure intracranial hemorrhage was not associated with thrombus length or density. Ninety day mRS was not associated with thrombus length or density. Conclusions: We have not found any significant associations between either thrombus length or density and likelihood of recanalization, time to achieve recanalization, intraprocedural complications, postprocedural hemorrhage or functional outcome at ninety days. These results do not support a predictive value for thrombus quantification in the evaluation of AIS.

scholarly journals Practice Pattern, Diagnostic Yield, and Long‐Term Prognostic Impact of Coronary Computed Tomographic Angiography

2020 ◽  
Vol 9 (18) ◽  
Author(s):  
Min Soo Cho ◽  
Jae‐Hyung Roh ◽  
Hanbit Park ◽  
Sang‐Cheol Cho ◽  
Do‐Yoon Kang ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Diagnostic Yield ◽  
Computed Tomographic Angiography ◽  
Therapeutic Interventions ◽  
Coronary Cta ◽  
Coronary Computed Tomographic Angiography ◽  
Computed Tomographic ◽  
Asymptomatic Patients ◽  
Tomographic Angiography

Background Although guidelines recommend the use of coronary computed tomographic angiography (CTA) in patients with stable pain syndromes, the clinical benefits of the use of coronary CTA in a broad spectrum of patients is unknown. We evaluated the contemporary practice pattern and diagnostic yield of coronary CTA and their impact on the subsequent diagnostic‐therapeutic cascade and clinical outcomes. Methods and Results We identified 39 906 patients without known coronary artery disease (CAD) who underwent coronary CTA between January 2007 and December 2013. The patients' demographic characteristics, risk factors, symptoms, results of coronary CTA, the appropriateness of downstream diagnostic and therapeutic interventions, and long‐term outcomes (death or myocardial infarction) were evaluated. The number of coronary CTAs had increased over time, especially in asymptomatic patients. Coronary CTA revealed that 6108 patients (15.3%) had obstructive CAD (23.7% of symptomatic and 9.3% of asymptomatic patients). Subsequent cardiac catheterization was performed in 19.2% of symptomatic patients (appropriate, 80.6%) and in 3.9% of asymptomatic patients (appropriate, 7.9%). The 5‐year rate of death or myocardial infarction was significantly higher in patients with obstructive CAD on CTA than those without (7.2% versus 3.0%; P <0.001; adjusted hazard ratio [95% CI], 1.34 [1.17–1.54]). However, obstructive CAD on CTA had limited added value over conventional risk factors for predicting death or myocardial infarction. Conclusions Although the use of coronary CTA had substantially increased, CTA had a low diagnostic yield for obstructive CAD, especially in asymptomatic patients. The use of CTA in asymptomatic patients seemed to have led to inappropriate subsequent diagnostic or therapeutic interventions without clinical benefit.

Ability of positive and negative contrast computed tomographic peritoneography to delineate canine liver lobe fissures

2019 ◽  
Vol 48 (8) ◽  
pp. 1444-1449
Author(s):  
Luis R. Rivas ◽  
Gabriela S. Seiler ◽  
Ian D. Robertson ◽  
Hongyu Ryu ◽  
Kyle G. Mathews
Keyword(s):  
Negative Contrast ◽  
Liver Lobe ◽  
Computed Tomographic

scholarly journals Cardiovascular magnetic resonance 4D flow analysis has a higher diagnostic yield than Doppler echocardiography for detecting increased pulmonary artery pressure

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Joao G. Ramos ◽  
Alexander Fyrdahl ◽  
Björn Wieslander ◽  
Gert Reiter ◽  
Ursula Reiter ◽  
...  
Keyword(s):  
Cardiovascular Magnetic Resonance ◽  
Magnetic Resonance ◽  
Pulmonary Artery ◽  
Doppler Echocardiography ◽  
Diagnostic Yield ◽  
Flow Analysis ◽  
Heart Catheterization ◽  
Lower Sensitivity ◽  
4D Flow ◽  
Transthoracic Doppler Echocardiography

Abstract Background Pulmonary hypertension is definitively diagnosed by the measurement of mean pulmonary artery (PA) pressure (mPAP) using right heart catheterization. Cardiovascular magnetic resonance (CMR) four-dimensional (4D) flow analysis can estimate mPAP from blood flow vortex duration in the PA, with excellent results. Moreover, the peak systolic tricuspid regurgitation (TR) pressure gradient (TRPG) measured by Doppler echocardiography is commonly used in clinical routine to estimate systolic PA pressure. This study aimed to compare CMR and echocardiography with regards to quantitative and categorical agreement, and diagnostic yield for detecting increased PA pressure. Methods Consecutive clinically referred patients (n = 60, median [interquartile range] age 60 [48–68] years, 33% female) underwent echocardiography and CMR at 1.5 T (n = 43) or 3 T (n = 17). PA vortex duration was used to estimate mPAP using a commercially available time-resolved multiple 2D slice phase contrast three-directional velocity encoded sequence covering the main PA. Transthoracic Doppler echocardiography was performed to measure TR and derive TRPG. Diagnostic yield was defined as the fraction of cases in which CMR or echocardiography detected an increased PA pressure, defined as vortex duration ≥15% of the cardiac cycle (mPAP ≥25 mmHg) or TR velocity > 2.8 m/s (TRPG > 31 mmHg). Results Both CMR and echocardiography showed normal PA pressure in 39/60 (65%) patients and increased PA pressure in 9/60 (15%) patients, overall agreement in 48/60 (80%) patients, kappa 0.49 (95% confidence interval 0.27–0.71). CMR had a higher diagnostic yield for detecting increased PA pressure compared to echocardiography (21/60 (35%) vs 9/60 (15%), p < 0.001). In cases with both an observable PA vortex and measurable TR velocity (34/60, 56%), TRPG was correlated with mPAP (R2 = 0.65, p < 0.001). Conclusions There is good quantitative and fair categorical agreement between estimated mPAP from CMR and TRPG from echocardiography. CMR has higher diagnostic yield for detecting increased PA pressure compared to echocardiography, potentially due to a lower sensitivity of echocardiography in detecting increased PA pressure compared to CMR, related to limitations in the ability to adequately visualize and measure the TR jet by echocardiography. Future comparison between echocardiography, CMR and invasive measurements are justified to definitively confirm these findings.

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