Usefulness of multidetector computed tomography in the evaluation of spinal neuro- musculoskeletal injuries

SummarySpinal trauma is commonly diagnosed in small animal practice. Although the first approach to the patient with spinal trauma includes survey spinal radiographs, an accurate evaluation of the injury often requires advanced imaging. Multidetector computed tomography has revolutionized computed tomography technology, providing near-isotropic volumetric representation of the complete body with exquisite anatomical detail in a brief scan time. This review aims to discuss the technical background, indications, and limitations of multidetector computed tomography in the assessment of spinal trauma with particular reference to skeletal, muscular and nervous spinal components.Online Supplementary Material: Please note that all figures for this paper are also available online at http://dx.doi.org/10.3415/VCOT-15-05-0082.

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Minimizing contrast medium doses to diagnose pulmonary embolism with 80-kVp multidetector computed tomography in azotemic patients

Acta Radiologica ◽

10.1080/02841850802657269 ◽

2009 ◽

Vol 50 (2) ◽

pp. 181-193 ◽

Cited By ~ 37

Author(s):

F. Holmquist ◽

K. Hansson ◽

F. Pasquariello ◽

J. Björk ◽

U. Nyman

Keyword(s):

Computed Tomography ◽

Pulmonary Embolism ◽

Body Weight ◽

Pulmonary Artery ◽

Multidetector Computed Tomography ◽

Routine Practice ◽

Dose Length Product ◽

Diagnostic Quality ◽

Scan Time ◽

Noise Ratio

Background: In diagnosing acute pulmonary embolism (PE) in azotemic patients, scintigraphy and magnetic resonance imaging are frequently inconclusive or not available in many hospitals. Computed tomography is readily available, but relatively high doses (30–50 g I) of potentially nephrotoxic iodine contrast media (CM) are used. Purpose: To report on the diagnostic quality and possible contrast-induced nephropathy (CIN) after substantially reduced CM doses to diagnose PE in azotemic patients using 80-peak kilovoltage (kVp) 16-row multidetector computed tomography (MDCT) combined with CM doses tailored to body weight, fixed injection duration adapted to scan time, automatic bolus tracking, and saline chaser. Material and Methods: Patients with estimated glomerular filtration rate (eGFR) <50 ml/min were scheduled to undergo 80-kVp MDCT using 200 mg I/kg, and those with eGFR ≥50 ml/min, 120-kVp MDCT with 320 mg I/kg. Both protocols used an 80-kg maximum dose weight and a fixed 15-s injection time. Pulmonary artery density and contrast-to-noise ratio were measured assuming 70 Hounsfield units (HU) for a fresh clot. CIN was defined as a plasma creatinine rise >44.2 µmol/l from baseline. Results: 89/148 patients (63/68 females) underwent 80-/120-kVp protocols, respectively, with 95% of the examinations being subjectively excellent or adequate. Mean values in the 80-/120-kVp cohorts regarding age were 82/65 years, body weight 66/78 kg, effective mAs 277/117, CM dose 13/23 g I, pulmonary artery density 359/345 HU, image noise (1 standard deviation) 24/21 HU, contrast-to-noise ratio 13/13, and dose-length product 173/258 mGy·cm. Only 1/65 and 2/119 patients in the 80- and 120-kVp cohorts, respectively, with negative CT and no anticoagulation suffered non-fatal thromboembolism during 3-month follow-up. No patient developed CIN. Conclusion: 80-kVp 16-row MDCT with optimization of injection parameters may be performed with preserved diagnostic quality, using markedly reduced CM doses compared with common routine practice, which should be to the benefit of patients at risk of CIN.

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Multidetector Computed Tomography of Spinal Trauma: A Pictorial Review

Current Problems in Diagnostic Radiology ◽

10.1067/j.cpradiol.2010.06.002 ◽

2011 ◽

Vol 40 (5) ◽

pp. 181-190

Author(s):

K. Srinivasan ◽

Ankur Gadodia ◽

Atin Kumar ◽

Shivanand Gamangatti

Keyword(s):

Computed Tomography ◽

Multidetector Computed Tomography ◽

Spinal Trauma ◽

Pictorial Review

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941 Integration of electroanatomic mapping and multidetector computed tomography as a guide for atrial fibrillation catheter ablation

EP Europace ◽

10.1016/s1099-5129(05)80663-4 ◽

2005 ◽

Vol 7 ◽

pp. 226-226

Keyword(s):

Computed Tomography ◽

Atrial Fibrillation ◽

Catheter Ablation ◽

Multidetector Computed Tomography ◽

Electroanatomic Mapping

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Assessment of vascular and biliary complications after liver transplantation: imaging with multidetector computed tomography angiography (MDCT-A), doppler us and contrast-enhanced us (CEUS)

Ultraschall in der Medizin - European Journal of Ultrasound ◽

10.1055/s-2007-988872 ◽

2007 ◽

Vol 28 (S 1) ◽

Author(s):

S Savelli ◽

S Pascoli ◽

M Atzori ◽

P Ialongo ◽

G Regine ◽

...

Keyword(s):

Computed Tomography ◽

Liver Transplantation ◽

Multidetector Computed Tomography ◽

Computed Tomography Angiography ◽

Biliary Complications ◽

Doppler Us ◽

Contrast Enhanced ◽

Multidetector Computed Tomography Angiography

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Analysis of Hepatic Capsular Enhancement Mimicking the Fitz-Hugh-Curtis Syndrome on a Multidetector Computed Tomography

Journal of the Korean Radiological Society ◽

10.3348/jkrs.2008.58.3.277 ◽

2008 ◽

Vol 58 (3) ◽

pp. 277

Author(s):

Ji Sang Park ◽

Seong Jin Park ◽

Hae Kyung Lee ◽

Boem Ha Yi ◽

Hyun Sook Hong ◽

...

Keyword(s):

Computed Tomography ◽

Multidetector Computed Tomography ◽

Fitz Hugh Curtis Syndrome

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Noninvasive Evaluation of Coronary Artery Bypass Grafts with 16-Slice Multidetector Computed Tomography

The Heart Surgery Forum ◽

10.1532/hsf98.20111075 ◽

2012 ◽

Vol 15 (1) ◽

pp. 12 ◽

Cited By ~ 1

Author(s):

Levent Sahiner ◽

Ali Oto ◽

Kudret Aytemir ◽

Tuncay Hazirolan ◽

Musturay Karcaaltincaba ◽

...

Keyword(s):

Computed Tomography ◽

Coronary Artery ◽

Diagnostic Accuracy ◽

Multidetector Computed Tomography ◽

Coronary Artery Bypass ◽

Predictive Value ◽

Artery Bypass ◽

Time Interval ◽

Mdct Angiography ◽

Sensitivity Specificity

Background: The aim of this study was to investigate the diagnostic accuracy of 16-slice multislice, multidetector computed tomography (MDCT) angiography for the evaluation of grafts in patients with coronary artery bypass grafting (CABG).Methods: Fifty-eight consecutive patients with CABG who underwent both MDCT and conventional invasive coronary angiography were included. The median time interval between the 2 procedures was 10 days (range, 1-32 days). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of MDCT for the detection of occluded grafts were calculated. The accuracy of MDCT angiography for detecting significant stenoses in patent grafts and the evaluability of proximal and distal anastomoses were also investigated.Results: Optimal diagnostic images could not be obtained for only 3 (2%) of 153 grafts. Evaluation of the remaining 150 grafts revealed values for sensitivity, specificity, PPV, NPV, and diagnostic accuracy of the MDCT angiography procedure for the diagnosis of occluded grafts of 87%, 97%, 94%, 93%, and 92%, respectively. All of the proximal anastomoses were optimally visualized. In 4 (8%) of 50 patent arterial grafts, however, the distal anastomotic region could not be evaluated because of motion and surgical-clip artifacts. The accuracy of MDCT angiography for the detection of significant stenotic lesions was relatively low (the sensitivity, specificity, PPV, and NPV were 67%, 98%, 50%, and 99%, respectively). The number of significant lesions was insufficient to reach a reliable conclusion, however.Conclusion: Our study showed that MDCT angiography with 16-slice systems has acceptable diagnostic performance for the evaluation of coronary artery bypass graft patency.

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