scholarly journals Diagnostic Performance of Extracellular Volume Quantified by Dual-Layer Dual-Energy CT for Detection of Acute Myocarditis

2021 ◽  
Vol 10 (15) ◽  
pp. 3286
Author(s):  
Salim Aymeric Si-Mohamed ◽  
Lauria Marie Restier ◽  
Arthur Branchu ◽  
Sara Boccalini ◽  
Anaelle Congi ◽  
...  
Keyword(s):  
Predictive Value ◽  
Diagnostic Performance ◽  
Acute Myocarditis ◽  
Extracellular Volume ◽  
Population Based ◽  
Dual Energy ◽  
Arterial Phase ◽  
Dual Energy Ct ◽  
P Value ◽  
Iodinated Contrast

Background: Myocardial extracellular volume (ECV) is a marker of the myocarditis inflammation burden and can be used for acute myocarditis diagnosis. Dual-energy computed tomography (DECT) enables its quantification with high concordance with cardiac magnetic resonance (CMR). Purpose: To investigate the diagnostic performance of myocardial ECV quantified on a cardiac dual-layer DECT in a population of patients with suspected myocarditis, in comparison to CMR. Methods: 78 patients were included in this retrospective monocenter study, 60 were diagnosed with acute myocarditis and 18 patients were considered as a control population, based on the 2009 Lake and Louise criteria. All subjects underwent a cardiac DECT in acute phase consisted in an arterial phase followed by a late iodine enhancement phase at 10 min after injection (1.2 mL/kg, iodinated contrast agent). ECV was calculated using the hematocrit level measured the day of DECT examinations. Non-parametric analyses have been used to test the differences between groups and the correlations between the variables. A ROC curve has been used to identify the optimal ECV cut-off discriminating value allowing the detection of acute myocarditis cases. A p value < 0.05 has been considered as significant. Results: The mean ECV was significantly higher (p < 0.001) for the myocarditis group compared to the control (34.18 ± 0.43 vs. 30.04 ± 0.53%). A cut-off value of ECV = 31.60% (ROC AUC = 0.835, p < 0.001) allows to discriminate the myocarditis with a sensitivity of 80% and a specificity of 78% (positive predictive value = 92.3%, negative predictive value = 53.8% and accuracy = 79.5%). Conclusion: Myocardial ECV enabled by DECT allows to diagnose the acute myocarditis with a cut-off at 31.60% for a sensitivity of 80% and specificity of 78%.

scholarly journals Comparison between Conventional Unenhanced and Virtual Unenhanced Imaging of Hepatopancreaticobiliary System with Third-Generation Dual-Source Dual-Energy CT—An Observational Study

2021 ◽  
Author(s):  
Swathigha Selvaraj ◽  
Niyas N. P. ◽  
Rupa Renganathan ◽  
Rajkumar Ramasamy ◽  
Rinoy Ram Anandan ◽  
...  
Keyword(s):  
Image Quality ◽  
Statistical Significance ◽  
Dual Energy ◽  
Arterial Phase ◽  
Dual Energy Ct ◽  
P Value ◽  
Diagnostic Image Quality ◽  
Third Generation ◽  
Dual Source ◽  
Virtual Unenhanced

Abstract Objectives The aims of our study were to assess the comparability of conventional unenhanced images (CUIs) of hepatopancreaticobiliary system with virtual unenhanced images (VUIs) derived from arterial and portal venous phases acquired in a third-generation, dual-source, dual-energy CT (DECT), and also to assess the best dataset among these VUIs. We also calculated the radiation effective dose (ED) reduction by eliminating noncontrast acquisition. Materials and Methods 60 patients were included in our study. Unenhanced images in single energy and contrast-enhanced images in dual-energy mode were acquired. Arterial virtual unenhanced (AVU) and portal virtual unenhanced (PVU) images were generated and compared with CUI, using both objective and subjective methods. The ED was calculated separately for each phase. Statistical significance between difference in mean attenuation values were analyzed using ANOVA and unpaired student t-test. Results In our study, the difference in mean attenuation of liver, spleen, and pancreas between the three phases—CU, AVU, and PVU—were insignificant with p-value > 0.05. This indicates that the values were comparable. Among the VUI, AVU images were statistically superior in image quality. Elimination of noncontrast CT from triple phase abdominal imaging can achieve an average ED reduction of 39%. Conclusions We conclude that VUI generated in third-generation, dual-source DECT has diagnostic image quality and can replace the CUI in triple-phase studies, with a mean ED reduction by 39%. The VUI obtained from arterial phase is superior to those obtained from portal venous phase.

Significance of simulated conventional images on dual energy CT after endovascular treatment for ischemic stroke

2019 ◽  
Vol 11 (9) ◽  
pp. 898-902 ◽  
Author(s):  
Ryo Ebashi ◽  
Atsushi Ogata ◽  
Masashi Nishihara ◽  
Kohei Inoue ◽  
Fumitaka Yoshioka ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Area Under The Curve ◽  
Hemorrhagic Transformation ◽  
Dual Energy ◽  
Dual Energy Ct ◽  
Iodinated Contrast ◽  
Conventional Ct

Background and purposeCT scans often reveal post-interventional cerebral hyperdensities (PCHDs) immediately after intra-arterial thrombectomy (IAT) for ischemic stroke. Dual energy CT (DE-CT) can indicate whether PCHDs are caused by hemorrhage or iodinated contrast. Hyperdense lesions, detected on DE-CT with the use of iodinated contrast, could be associated with delayed hemorrhagic transformation and poor outcome. However, the quantitative indicators in DE-CT for predicting delayed hemorrhagic transformation remain unclear. We assessed such indicators for predicting delayed hemorrhagic transformation.Material and methodsWe retrospectively analyzed 52 consecutive acute ischemic stroke patients who underwent IAT. Simulated conventional CT (sCCT) images were obtained immediately after a DE-CT scan. Virtual, unenhanced, non-contrast (VNC) imaging was performed after reconstruction. Hounsfield units (HU) of the infarct areas observed on the sCCT were measured. The association of HU on sCCT with hemorrhage on VNC and delayed parenchymal hemorrhage (PH) was evaluated.ResultsThe HU of sCCT with hemorrhage on VNC was significantly higher than without it (377.9±385 HU vs 83.5±37.9 HU; P<0.0001). The cut-off index was 80 HU, which displayed 100% sensitivity, 63.8% specificity, 22.3% positive predictive value, and 100% negative predictive value (P=0.0001, area under the curve (AUC)=0.89). The HU with delayed PH was substantially higher than without it (250.8±382.2 HU vs 93.7±64.8 HU; P=0.01). The cut-off index was 78 HU, which showed 100% sensitivity, 61% specificity, 25% positive predictive value, and 100% negative predictive value (P=0.049, AUC=0.76).ConclusionsCCT images on DE-CT are useful for excluding intracerebral hemorrhage and delayed PH.

scholarly journals In vivo identification of uric acid stones with dual-energy CT: diagnostic performance evaluation in patients

2009 ◽  
Vol 35 (5) ◽  
pp. 629-635 ◽  
Author(s):  
Paul Stolzmann ◽  
Marko Kozomara ◽  
Natalie Chuck ◽  
Michael Müntener ◽  
Sebastian Leschka ◽  
...  
Keyword(s):  
Uric Acid ◽  
Performance Evaluation ◽  
Diagnostic Performance ◽  
Dual Energy ◽  
Dual Energy Ct ◽  
Uric Acid Stones

Dual energy CT after stroke thrombectomy alters assessment of hemorrhagic complications

Neurology ◽  
2019 ◽  
Vol 93 (11) ◽  
pp. e1068-e1075 ◽  
Author(s):  
Håkan Almqvist ◽  
Staffan Holmin ◽  
Michael V. Mazya
Keyword(s):  
Predictive Value ◽  
Dual Energy ◽  
Considerable Proportion ◽  
Dual Energy Ct ◽  
Endovascular Thrombectomy ◽  
Weighted Image ◽  
Diagnosis And Classification ◽  
Comprehensive Stroke Center ◽  
Stroke Center

ObjectiveTo determine whether dual energy CT with a combined approach (cDECT) using a plain noncontrast monochromatic CT (pCT), a water-weighted image after iodine removal, and an iodine-weighted image changes the diagnosis and classification of intracranial hemorrhage (ICH) after endovascular thrombectomy (EVT) in acute ischemic stroke compared to a pCT image alone without separate water and iodine weighting.MethodDuring 2012 to 2016, 372 patients at our comprehensive stroke center underwent DECT scans within 36 hours after EVT. Two readers evaluated pCT compared to a second reading with cDECT, establishing the diagnosis of ICH and grading it per the Heidelberg and Safe Implementation of Thrombolysis in Stroke–Monitoring Study (SITS-MOST) classifications.ResultUsing cDECT changed the ICH diagnosis to contrast staining only in 34% (52 of 152), modified the ICH grade in 10% (15 of 152), and diagnosed initially undetected ICH in 2% (5 of 220). pCT alone had 95% sensitivity, 80% specificity, 66% positive predictive value, 98% negative predictive value, and 85% accuracy for ICH compared to cDECT. Interreader agreement on the presence of ICH increased with cDECT compared to pCT (Cohen κ = 0.77 [95% confidence interval 0.69–0.84] vs 0.68 [0.61–0.76]).ConclusioncDECT within 36 hours after EVT changes the radiologic report regarding posttreatment ICH in a considerable proportion of patients undergoing EVT compared to pCT alone. This could affect decision-making regarding monitoring, secondary prevention, and prognostication. The cDECT scan could improve the interpretation consistency of high-attenuating changes on post-EVT images.

Diagnostic Performance of Dual-Energy CT for the Detection of Traumatic Bone Marrow Lesions in the Ankle: Comparison with MR Imaging

Radiology ◽  
2012 ◽  
Vol 264 (1) ◽  
pp. 164-173 ◽  
Author(s):  
Roman Guggenberger ◽  
Ralph Gnannt ◽  
Juerg Hodler ◽  
Bernhard Krauss ◽  
Guido A. Wanner ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Mr Imaging ◽  
Diagnostic Performance ◽  
Dual Energy ◽  
Dual Energy Ct ◽  
Bone Marrow Lesions

Cerebral contrast staining mimicking parenchymal haemorrhage in a stroke patient

2020 ◽  
Vol 13 (12) ◽  
pp. e236400
Author(s):  
Elvin Yuan Ting Lim ◽  
Saravana Kumar Swaminathan
Keyword(s):  
Ct Scan ◽  
Middle Cerebral Artery ◽  
Signs And Symptoms ◽  
Dual Energy ◽  
Dual Energy Ct ◽  
Iodinated Contrast ◽  
Acute Infarct ◽  
The Right ◽  
The Brain

A 75-year-old female patient presented with signs and symptoms of a right hemispheric syndrome. A CT scan of the brain with angiogram showed an acute infarct in the right middle cerebral artery (MCA) territory secondary to thromb-occlusion of the M1 segment of the right MCA. A follow-up CT scan 2 weeks later showed a large hyperdense region in the infarcted area. With the aid of a dual-energy CT scan, this was eventually shown to be due to contrast staining from an earlier administration of iodinated contrast on the same day, rather than frank haemorrhagic conversion of the recent right MCA infarct.

Quantification of liver extracellular volume using dual-energy CT: utility for prediction of liver-related events in cirrhosis

2020 ◽  
Vol 30 (10) ◽  
pp. 5317-5326
Author(s):  
Seongjun Bak ◽  
Ji Eun Kim ◽  
Kyungsoo Bae ◽  
Jae Min Cho ◽  
Ho Cheol Choi ◽  
...  
Keyword(s):  
Extracellular Volume ◽  
Dual Energy ◽  
Dual Energy Ct
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