1.RE: An Unusual Course of Right Coronary Artery Originating from Sinoatrial Node Artery.
Kemal KARA ; Ersin OZTURK ; Muzaffer SAGLAM
Korean Journal of Radiology 2014;15(6):878-878
No abstract available.
*Cardiac-Gated Imaging Techniques
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Coronary Vessel Anomalies/*radiography
;
Female
;
Humans
;
Male
;
Sinoatrial Node/*radiography
;
Tomography, X-Ray Computed/*methods
2.Prospectively Electrocardiogram-Gated High-Pitch Spiral Acquisition Mode Dual-Source CT Coronary Angiography in Patients with High Heart Rates: Comparison with Retrospective Electrocardiogram-Gated Spiral Acquisition Mode.
Kai SUN ; Rui Juan HAN ; Li Jun MA ; Li Jun WANG ; Li Gang LI ; Jiu Hong CHEN
Korean Journal of Radiology 2012;13(6):684-693
OBJECTIVE: To assess the image quality and effective radiation dose of prospectively electrocardiogram (ECG)-gated high-pitch spiral acquisition mode (flash mode) of dual-source CT (DSCT) coronary angiography (CTCA) in patients with high heart rates (HRs) as compared with retrospectively ECG-gated spiral acquisition mode. MATERIALS AND METHODS: Two hundred and sixty-eight consecutive patients (132 female, mean age: 55 +/- 11 years) with mean HR > 65 beats per minute (bpm) were prospectively included in this study. The patients were divided into two groups. Collection was performed in group A CTCA using flash mode setting at 20-30% of the R-R interval, and retrospectively ECG-gated spiral acquisition mode in group B. The image noise, contrast-to-noise ratio (CNR), image quality scores, effective radiation dose and influencing factors on image quality between the two groups were assessed. RESULTS: There were no significant differences in image quality scores and proportions of non-diagnostic coronary artery segments between two groups (image quality scores: 1.064 +/- 0.306 [group A] vs. 1.084 +/- 0.327 [group B], p = 0.063; proportion of non-diagnostic coronary artery segments: segment-based analysis 1.52% (group A) vs. 1.74% (group B), p = 0.345; patient-based analysis 7.5% (group A) vs. 6.7% (group B), p = 0.812). The estimated radiation dose was 1.0 +/- 0.16 mSv in group A and 7.1 +/- 1.05 mSv in group B (p = 0.001). CONCLUSION: In conclusion, in patients with HRs > 65 bpm without cardiac arrhythmia, the prospectively high-pitch spiral-acquisition mode with image-acquired timing set at 20-30% of the R-R interval provides a similar image quality and low rate of non-diagnostic coronary segments to the retrospectively ECG-gated low-pitch spiral acquisition mode, with significant reduction of radiation exposure.
Arrhythmias, Cardiac/*diagnosis
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Artifacts
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*Cardiac-Gated Imaging Techniques
;
*Coronary Angiography
;
*Electrocardiography
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Female
;
*Heart Rate
;
Humans
;
Male
;
Middle Aged
;
*Tomography, Spiral Computed
3.High-Definition Computed Tomography for Coronary Artery Stent Imaging: a Phantom Study.
Wen Jie YANG ; Ke Min CHEN ; Li Fang PANG ; Ying GUO ; Jian Ying LI ; Huang ZHANG ; Zi Lai PAN
Korean Journal of Radiology 2012;13(1):20-26
OBJECTIVE: To assess the performance of a high-definition CT (HDCT) for imaging small caliber coronary stents (< or = 3 mm) by comparing different scan modes of a conventional 64-row standard-definition CT (SDCT). MATERIALS AND METHODS: A cardiac phantom with twelve stents (2.5 mm and 3.0 mm in diameter) was scanned by HDCT and SDCT. The scan modes were retrospective electrocardiography (ECG)-gated helical and prospective ECG-triggered axial with tube voltages of 120 kVp and 100 kVp, respectively. The inner stent diameters (ISD) and the in-stent attenuation value (AVin-stent) and the in-vessel extra-stent attenuation value (AVin-vessel) were measured by two observers. The artificial lumen narrowing (ALN = [ISD - ISDmeasured]/ISD) and artificial attenuation increase between in-stent and in-vessel (AAI = AVin-stent - AVin-vessel) were calculated. All data was analyzed by intraclass correlation and ANOVA-test. RESULTS: The correlation coefficient of ISD, AVin-vessel and AVin-stent between the two observers was good. The ALNs of HDCT were statistically lower than that of SDCT (30 +/- 5.7% versus 35 +/- 5.4%, p < 0.05). HDCT had statistically lower AAI values than SDCT (15.7 +/- 81.4 HU versus 71.4 +/- 90.5 HU, p < 0.05). The prospective axial dataset demonstrated smaller ALN than the retrospective helical dataset on both HDCT and SDCT (p < 0.05). Additionally, there were no differences in ALN between the 120 kVp and 100 kVp tube voltages on HDCT (p = 0.05). CONCLUSION: High-definition CT helps improve measurement accuracy for imaging coronary stents compared to SDCT. HDCT with 100 kVp and the prospective ECG-triggered axial technique, with a lower radiation dose than 120 kVp application, may be advantageous in evaluating coronary stents with smaller calibers (< or = 3 mm).
Analysis of Variance
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Cardiac-Gated Imaging Techniques/methods
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Coronary Disease/*radiography/*therapy
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Humans
;
Phantoms, Imaging
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Radiation Dosage
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Radiographic Image Interpretation, Computer-Assisted
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*Stents
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Tomography, Spiral Computed/*methods
4.CT Radiation Dose Optimization and Estimation: an Update for Radiologists.
Korean Journal of Radiology 2012;13(1):1-11
In keeping with the increasing utilization of CT examinations, the greater concern about radiation hazards from examinations has been addressed. In this regard, CT radiation dose optimization has been given a great deal of attention by radiologists, referring physicians, technologists, and physicists. Dose-saving strategies are continuously evolving in terms of imaging techniques as well as dose management. Consequently, regular updates of this issue are necessary especially for radiologists who play a pivotal role in this activity. This review article will provide an update on how we can optimize CT dose in order to maximize the benefit-to-risk ratio of this clinically useful diagnostic imaging method.
Body Size
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Cardiac-Gated Imaging Techniques/methods
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Humans
;
*Radiation Dosage
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Radiographic Image Interpretation, Computer-Assisted
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Radiometry
;
Risk Assessment
;
Tomography, X-Ray Computed/*methods
5.Evaluating a Thrombosed Azygous Vein Aneurysm Combined with Pulmonary Arterial Thromboembolism by ECG-Gated Multidetector CT: a Case Report.
Ji Yeon YANG ; Dong Hun KIM ; June Hyuk LEE ; Eun Ha SUK
Korean Journal of Radiology 2011;12(6):754-756
Azygous vein aneurysm is a rare congenital lesion that needs to be differentiated from mediastinal mass lesions. Although almost of these anomalies are asymptomatic lesions, we experienced an interesting case in which a thrombus within an azygous vein aneurysm in a 75-year-old woman caused pulmonary thromboembolism. The patient was managed by medical treatment for one month and then the thrombus within both the azygous vein aneurysm and the pulmonary arteries completely resolved.
Aged
;
Aneurysm/complications/*radiography
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*Azygos Vein
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*Cardiac-Gated Imaging Techniques
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Female
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Humans
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*Multidetector Computed Tomography
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Pulmonary Embolism/etiology/*radiography
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Thrombosis/complications/*radiography
6.High-pitch dual-source CT in prospectively electrocardiogram-triggered spiral double scanning mode for diagnosing coronary artery patency.
Xiaobo YANG ; Junjie YANG ; Feng TIAN ; Ying ZHOU ; Qi WANG ; Huawei ZHANG ; Luoshan DU ; Yundai CHEN
Journal of Southern Medical University 2013;33(11):1605-1610
OBJECTIVETo assess the image quality, diagnostic accuracy and effective radiation dose of prospectively ECG- triggered high-pitch spiral double scanning (Double Flash) mode of computed tomography coronary angiography (CTCA) using dual-source CT for the diagnosis of significant coronary stenoses.
METHODSPatients underwent both CTCA in Double Flash mode and conventional coronary angiography (CAG) and were divided into two groups according to heart rate (HR), namely group A with HR <65/min (62 cases) and group B with HR between 65 and 80/min (52 cases). All the coronary segments were evaluated by two blinded and independent observers for image quality on a four-point scale and for the presence of significant coronary stenoses (defined as a diameter narrowing exceeding 50%). CAG served as the reference standard for analyzing the diagnostic accuracy of Double Flash mode images on the level of both patients and vessels. Radiation dose values were calculated using the dose-length product.
RESULTSA total of 114 patients were enrolled and 1725 vessel segments were displayed. In terms of image quality, the diagnosable segments accounted for 98.5% (919/933) in group A and 97.3% (770/792) in group B. In the per-patient analysis, the diagnostic sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 100%, 90.5%, 88.2%, 100% and 96.7% in group A and were 100%, 88.5%, 94.5%, 100% and 96.2% in group B, respectively. The mean effective radiation dose was 1.63∓0.52 mSv.
CONCLUSIONDouble Flash spiral protocol of dual-source CTCA can acquire good image quality and yield high diagnostic accuracy for assessment of coronary artery stenoses at a low radiation dose in patients with HR between 65 and 80/min.
Aged ; Cardiac-Gated Imaging Techniques ; Coronary Angiography ; Coronary Stenosis ; diagnosis ; diagnostic imaging ; pathology ; physiopathology ; Coronary Vessels ; diagnostic imaging ; Female ; Heart Rate ; Humans ; Male ; Middle Aged ; Radiation Dosage ; Sensitivity and Specificity ; Tomography, Spiral Computed
7.Ventriculus Terminalis in Adults: Unusual Magnetic Resonance Imaging Features and Review of the Literature.
Sang Hyun SUH ; Tae Sub CHUNG ; Seung Koo LEE ; Yong Eun CHO ; Keun Su KIM
Korean Journal of Radiology 2012;13(5):557-563
OBJECTIVE: The ventriculus terminalis (VT) in adults is a rare pathology. We report various MR imaging features of the adult VT. MATERIALS AND METHODS: Ten patients were included in this retrospective review.. All patients had undergone magnetic resonance (MR imaging with a surface coil that used two different 1.5T MR systems. All patients had undergone initial and follow-up MR imaging with contrast enhancement using gadopentate dimeglumine. Three patients underwent additional MR imaging using the echocardiogram-gated spatial modulation of magnetization (SPAMM) technique. If a shift in tagging band during the systolic phase was less than half of the band space, it was defined as a "non-pulsatile fluid". Two neuroradiologists independently reviewed these images, while clinical symptoms and outcomes were statistically analyzed between the treated and non-treated group. RESULTS: All cases presented an intramedullary cystic lesion in the conus medullaris and showed the same signal intensity as CSF. Three VTs had intracystic septation and cord edema, which were pathologically confirmed after surgery; two of these were associated with kyphotic deformity and spinal arteriovenous malformation. SPAMM-MRI of 3 patients demonstrated non-pulsatile fluid motion within the VT. In the treated group, clinical symptoms improved better than the non-treated group. CONCLUSION: The adult VT shows some unusual imaging features, including septation, cord edema, and coexistence of a spinal AVM, as well as the typical findings. Surgical maneuvers may be considered as a treatment option in adult VT with progressive neurological symptoms.
Adult
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Cardiac-Gated Imaging Techniques
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Contrast Media/diagnostic use
;
Cysts/*diagnosis/physiopathology
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Diagnosis, Differential
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Female
;
Gadolinium DTPA/diagnostic use
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Humans
;
Magnetic Resonance Imaging/*methods
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Male
;
Retrospective Studies
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Spinal Cord Diseases/*diagnosis/physiopathology
8.Clinical value of ECG-gated dual-source computed tomography and angiography in assessing coarctation of aorta.
Liqing PENG ; Zhigang YANG ; Jianqun YU ; Zhigang CHU ; Dongdong CHEN ; Yi LUO
Journal of Biomedical Engineering 2013;30(1):89-94
The purpose of this study was to explore the clinical value of ECG-gated dual-source CT angiography (DSCTA) in evaluating coarctation of aorta (CoA). 23 patients suspected with CoA underwent DSCTA and transthoracic echocardiography (TTE). Surgical results were taken as reference standard. 23 patients were diagnosed with CoA, 12 cases had focal stenosis of aorta, while 11 had tubular stenosis. 19 cases were associated with other cardiovascular malformations, including 5 cases of hypoplastic aortic arch, 5 of patent ductus arteriosus, 10 of ventricular septal defect, 2 of bicuspid aortic valve, 4 of collateral arteries, 2 of aberrant left subclavian artery and 2 of persistent left superior vena cava, respectively. The mean diameter of stenotic segment of aorta was (7.0 +/- 3.7) mm. In 9 patients with tubular CoA, the diameter and length of stenotic segment of aorta were (6.2 +/- 7. 3) mm and (29.2 +/- 5.9) mm, respectively. The accuracies of DSCTA and TTE in the diagnosis of CoA were 100% and 91.3% (P > 0.05), respectively. It is well concluded that ECG-gated DSCTA could accurately evaluate CoA and associated cardiovascular malformations, and provide detailed anatomic information before surgery.
Adolescent
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Adult
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Angiography
;
methods
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Aortic Coarctation
;
diagnostic imaging
;
surgery
;
Cardiac-Gated Imaging Techniques
;
methods
;
Child
;
Child, Preschool
;
Contrast Media
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Echocardiography
;
Electrocardiography
;
methods
;
Female
;
Humans
;
Infant
;
Male
;
Tomography, X-Ray Computed
;
methods
;
Young Adult
9.Three-dimensional volume rendering for dynamic characteristics of secundum atrial septal defect during various phases of the cardiac cycle and the impact on occluder selection.
Hui Jun SONG ; Shi Guo LI ; Qiong LIU ; Jing Lin JIN ; Kai YANG ; Jing ZHANG ; Zhong Ying XU ; Xiang Bin PAN ; Shi Hua ZHAO
Chinese Journal of Cardiology 2022;50(8):805-810
Objective: To investigate the dynamic change of the secundum atrial septal defect (ASD) throughout the cardiac cycle, and assess its impact on occluder selection. Methods: This study retrospectively analyzed 35 patients with ASD who received electrocardiogram-gated coronary CT angiography (CCTA) throughout the cardiac cycle as well as interventional closure therapy in Fuwai Hospital from December 2016 to December 2019. The raw data were reconstructed into 20 phasic images of RR intervals (RRI) ranging from 0 to 95% in an increment of 5% and transmitted to a workstation for postprocessing. For each phase image, CT virtual endoscopy reconstruction technique (CTVE) was used to provide views of ASD. Axial sequence assisted CT volumetric measurement (CTAS) was used to calculate the maximum dimensions in axial planes (Da) and in superior-inferior direction (Db). Using a formula for converting circumference to diameter, the equivalent circle dimensions were calculated (De, De=minor axis+2 (major axis-minor axis)/3). Taking the data of 75% RRI phase, the patients were divided into Da75%RRI≥Db75%RRI group and Da75%RRI
Adult
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Cardiac-Gated Imaging Techniques
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Computed Tomography Angiography
;
Coronary Angiography
;
Electrocardiography/methods*
;
Female
;
Heart Septal Defects, Atrial/surgery*
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Humans
;
Imaging, Three-Dimensional
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Male
;
Middle Aged
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Retrospective Studies
;
Septal Occluder Device
10.Anatomy of the Sinoatrial Nodal Branch in Korean Population: Imaging with MDCT.
Yong Sub SONG ; Whal LEE ; Eun Ah PARK ; Jin Wook CHUNG ; Jae Hyung PARK
Korean Journal of Radiology 2012;13(5):572-578
OBJECTIVE: To evaluate, on a retrospective basis, the anatomic characteristics of the arterial supply to the sinoatrial node (SAN) in the Korean population using an ECG-gated multi-detector CT (MDCT). MATERIALS AND METHODS: The electrocardiographic-gated MDCTs of 500 patients (258 men and 242 women; age range, 17-83 years; mean age, 58.6 +/- 12.04 years) were analyzed retrospectively. In each case, the SAN artery (arteries) was named according to a special nomenclature with regard to origin, course, and termination. RESULTS: A total of 516 SAN arteries were visualized in 496 patients. The SAN was supplied by a single artery in 476 (96.4%) cases and by 2 arteries in 18 (3.6%) cases. The SAN originated from the right coronary artery in 265 (53.4%) cases and from the left circumflex in 213 (43%) cases. CONCLUSION: This study can provide basic data on variations of the SAN artery in the Korean population.
Adolescent
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Adult
;
Aged
;
Aged, 80 and over
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*Cardiac-Gated Imaging Techniques
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Coronary Vessel Anomalies/*radiography
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Female
;
Humans
;
Male
;
Middle Aged
;
Republic of Korea
;
Retrospective Studies
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Sinoatrial Node/*radiography
;
Tomography, X-Ray Computed/*methods