Clinical Application of Acute Ischemic Stroke in Perfusion Computed Tomography / 의학물리

Recent advent of 64-multidetctor (MD) CT enables more coverage of Z-axis in the perfusion imaging. The purpose of this study was to evaluate the clinical usefulness of perfusion CT by using 64-MD CT in detecting the lesion in patients with acute stroke. The perfusion CT was performed by using 64-MD CT in 62 consecutive patients who were initially suspected to have subacute ischemic stroke symptoms during the period of recent 9 months. These patients had subacute stroke (n=62). CT scanning was conducted with Jog Mode which provided 16 imaging slices with 5 mm of slice thickness, and 8 cm of coverage in Z-axis. Scan interval was 1 seconds for each imaging slice and total 15 scans were repeated. After CT scanning, perfusion maps (CBV, CBF, MTT and TTP) were created at Extended Brilliance Workstation. The CBV and CBF maps showed that lesions were smaller images. While on the MTT and TTP map lesions were seen to be larger fifty-one were large than they appeared on these images. Two slices of perfusion maps obtained at the level of the basal ganglia were chosen to simulate conventional older perfusion CT with 8 cm of coverage in Z-axis. TTP and MTT maps may be clinically useful for evaluation of the penumbral zone in cases of aubacute cerebral ischemic stroke. The perfusion CT is useful in the assessment of acute stroke as an initial imaging modality.

MTF Evaluation and Clinical Application according to the Characteristic Kernels in the Computed Tomography / 의학물리

Our objective was to evaluate the clinical feasibility of spatial domain filtering as an alternative to additional image reconstruction using different kernels in CT. Kernels were grouped as H30 (head medium smooth), B30 (body medium smooth), S80 (special) and U95 (ultra sharp). Derived from thin collimated source images, four sets of images were generated using phantom kernels. MTF (50%, 10%, 2%) measured with H30 (3.25, 5.68, 7.45 lp/cm), B30 (3.84, 6.25, 7.72 lp/cm), S80 (4.69, 9.49, 12.34 lp/cm), and U95 (14.19, 20.31, 24.67 lp/cm). Spatial resolution for the U95 kernel (0.6 mm) was 33.3% greater than that of the H30 and B30 (0.8 mm) kernels. Initially scanned kernels images were rated for subjective image quality, using a five-point scale. Image scanned with a convolution kernel led to an increase in noise (U95), whereas the results for CT attenuation coefficient were comparable. CT images increase the diagnostic accuracy in head (H30), abdomen (B30), temporal bone and lung (U95) kernels may be controlled by adjusting CT various algorithms, which should be adjusted to take into account the kernels of the CT undergoing the examination.

Subcutaneous Injection Contrast Media Extravasation : 3D CT Appearance / 의학물리

We report a case of an accidental extravasation of contrast material. A large-volume extravasation occurred in an adult during spiral contrast-enhanced CT. The amount of contrast material extravasated was 47 ml. The patient had a swelling of the dorsum right hand. The extravasation injury site was determined by CT scanning. The extavasation case was examined using five separate display techniques: axial, multi planar reformation (MPR), maximum intensity projection (MIP), volume rendering, and shaded-surfaced display (SSD). This paper introduces extravasation with the CT and the three-dimensional appearance.