Three-dimensional reconstruction with dual-source computed tomography for evaluating graft deformation and bone tunnel position following reconstruction of the anterior cruciate ligament.

OBJECTIVE: Considering the limitations of MRI and X-ray and few studies on the use of dual-source computed tomography (DSCT) in anterior cruciate ligament (ACL) reconstruction are limited, this study explored the clinical application of DSCT for three-dimensional reconstruction of graft deformation and bone tunnel position images following ACL reconstruction. METHODS: The data of 123 patients who underwent single-bundle ACL reconstruction under arthroscopy from January 2017 to October 2021 were retrieved. Two weeks after surgery, DSCT was used to assess graft deformation and tunnel widening. Based on the positions of ACL graft deformation and bone tunnel, the patients were divided into a collision group (n = 35), posterior group (n = 37) and satisfactory group (n = 51). The groups were compared in terms of the relative position of the central point of the femoral tunnel (FX, FY) and tibial tunnel (TX, TY), the straight-line distances of the grafts (L), the sagittal plane angle (∠α), and the coronal plane angle (∠ß) between the two bone tunnels. RESULTS: Tx, Ty, ∠α and âˆ ß were significantly different among the three groups, while no difference in Fx, Fy and L were observed. Tx, Ty and ∠α were identified as independent risk factors for collisions between the graft and intercondylar notch. Ty and ∠α were independent risk factors for posterior deviation of tibial tunnel position. CONCLUSION: DSCT demonstrated promising clinical applicability to evaluate graft deformation and bone tunnel position after reconstruction of ACL and could guide preoperative positioning and postoperative evaluation.

Lung volume determination by dual-source computed tomography in infants with pulmonary artery sling: a case-control study.

Background: Pulmonary artery sling (PAS) is associated with tracheal stenosis and left pulmonary artery (LPA) dysplasia in infants, both developmental abnormalities that may lead to pulmonary hypoplasia and lung volume changes. As such, we aimed to monitor the effects of tracheal stenosis and pulmonary vascular malformation on lung volumes in infants with PAS and their correlation with lung volumes in infants with PAS using dual-source computed tomography (DSCT). Methods: A case-control study was performed. From May 2009 to June 2017, we retrospectively enrolled patients with surgically confirmed PAS and compared them to matched normal controls (A healthy control group comprising age- and gender-matched patients with adequate imaging data was used for the comparisons.). All the patients underwent DSCT examinations. We measured and compared the diameters of the trachea, main bronchus, and main pulmonary artery (MPA) and its branches, and both lung volumes on the axial, and reconstructed CT images. Results: There were no statistical differences in the diameters of the MPA or right pulmonary artery (RPA) between patients (N=15) and controls (N=28). The diameter of the main bronchus, the bilateral trachea and the left pulmonary artery were all smaller in the PAS group than in the control group, and significant differences were evident in the left lung volume the right lung volume, and the right-to-left lung volume ratio between the 2 groups. Pearson's correlation and linear regression analyses between the diameters of the trachea and MPA, total lung volume, ipsilateral bronchial and pulmonary artery branches, and ipsilateral lung volume ranged from 0.71 to 0.87 and 0.57 to 0.77 for the control and PAS groups, respectively. Conclusions: Tracheal stenosis and LPA dysplasia in infants with PAS cause alterations in lung tissue morphology and physiological development, resulting in reduced bilateral lung volumes.

Thoracic CTA in infants and young children: Image quality of dual-source CT (DSCT) with high-pitch spiral scan mode (turbo flash spiral mode) with or without general anesthesia with free-breathing technique.

PURPOSE: To determine whether diagnostic quality thoracic computed tomography angiography (CTA) studies can be obtained without general anesthesia (GA) in infants and young children using dual-source computed tomography (DSCT) with turbo flash spiral mode (TFSM) and free-breathing technique. MATERIALS AND METHODS: All consecutive infants and young children (≤ 6 years old) who underwent thoracic CTA studies from January 2018 to October 2020 for suspected congenital thoracic disorders were categorized into two groups: with GA (Group 1) and without GA (Group 2). All thoracic CTA studies were performed on a DSCT scanner using TFSM and free-breathing technique. Two pediatric thoracic radiologists independently evaluated motion artifact in three lung zones (upper, mid, and lower). Degree of motion artifact was graded 0-3 (0, none; 1, mild; 2, moderate; and 3, severe). Logistic models adjusted for age and gender were used to compare the degree of motion artifact between lung zones. Interobserver agreement between reviewers was evaluated with kappa statistics. RESULTS: There were a total of 73 pediatric patients (43 males (59%) and 30 females (41%); mean age, 1.4 years; range, 0-5.9 years). Among these 73 patients, 42 patients (58%) underwent thoracic CTA studies with GA (Group 1) and the remaining 31 patients (42%) underwent thoracic CTA studies without GA (Group 2). Overall, the degree of motion artifact was higher for Group 2 (without GA). However, only a very small minority (1/31, 3%) of Group 2 (without GA) thoracic CTA studies had severe motion artifact. There was no significant difference between the two groups with respect to the presence of severe motion artifact (odds ratio [OR] = 6, p = .222). When two groups were compared with respect to the presence of motion artifact for individual lung zones, motion artifact was significantly higher in the upper lung zone for Group 2 (without GA) (OR = 20, p = .043). Interobserver agreement for motion artifact was high, the average Kappa being 0.81 for Group 1 and 0.95 for Group 2. CONCLUSION: Although the degree of motion artifact was higher in the group without GA, only a small minority (3%) of thoracic CTA studies performed without GA had severe motion artifact, rendering the study nondiagnostic. Therefore, the results of this study support the use of thoracic CTA without GA using DSCT with TFSM and free-breathing in infants and young children. In addition, given that motion artifact was significantly higher in the upper lung zone without GA, increased stabilization in the upper chest and extremities should be considered.

Association between coronary artery atherosclerosis and plasma glucose levels assessed by dual-source computed tomography.

BACKGROUND: To assess the association between coronary artery atherosclerosis (CAA) and plasma glucose parameters in a randomly selected cohort of asymptomatic, community-dwelling, Chinese adults by dual-source computed tomography (DSCT). METHODS: We randomly selected participants and classified them into three groups based on their plasma glucose levels: normal glucose regulation (NGR), pre-diabetes, and diabetes mellitus (DM). The participants underwent DSCT, and those identified with CAA were divided into four groups according to the severity of their coronary artery stenosis. We analyzed the composition of plaques in all coronary artery segments according to the American Heart Association's (AHA) guidelines. We compared the severity of coronary artery stenosis and the plaque composition with plasma glucose parameters among participants. RESULTS: Out of a total of 335 participants, 118 were found to have CAA. The prevalence of CAA was highest (P value for trend =0.031) in the diabetic group (67.7%) followed by the pre-diabetic group (35.1%) then the NGR group (27.7%). Both calcified and mixed plaques were found in the coronary arteries of the diabetic group while mixed and non-calcified plaques predominated in the pre-diabetic and the NGR groups. When data from all subjects with CAA were analyzed, blood glucose parameters, fasting plasma glucose (FPG), 2-hr postprandial plasma glucose (PPG), and hemoglobin A1c (HbA1c), exhibited a positive correlation with the severity of coronary stenosis (P<0.05). Multivariable logistic regression models indicated a significantly higher risk of CAA among the diabetic patients. Triglyceride levels were positively correlated with the blood glucose parameters among the three groups while LDL-C was elevated in the DM group but not in the pre-diabetic group compared to the NGR group. CONCLUSIONS: The severity of CAA exhibited a direct correlation with the blood glucose parameters, FPG, PPG, and HbA1c. DSCT can accurately detect the presence and distribution of CAA in asymptomatic, community-dwelling subjects. DSCT is a useful screening tool for coronary artery disease (CAD).

Nonrigid registration with corresponding points constraint for automatic segmentation of cardiac DSCT images.

BACKGROUND: Dual-source computed tomography (DSCT) is a very effective way for diagnosis and treatment of heart disease. The quantitative information of spatiotemporal DSCT images can be important for the evaluation of cardiac function. To avoid the shortcoming of manual delineation, it is imperative to develop an automatic segmentation technique for 4D cardiac images. METHODS: In this paper, we implement the heart segmentation-propagation framework based on nonrigid registration. The corresponding points of anatomical substructures are extracted by using the extension of n-dimensional scale invariant feature transform method. They are considered as a constraint term of nonrigid registration using the free-form deformation, in order to restrain the large variations and boundary ambiguity between subjects. RESULTS: We validate our method on 15 patients at ten time phases. Atlases are constructed by the training dataset from ten patients. On the remaining data the median overlap is shown to improve significantly compared to original mutual information, in particular from 0.4703 to 0.5015 ([Formula: see text]) for left ventricle myocardium and from 0.6307 to 0.6519 ([Formula: see text]) for right atrium. CONCLUSIONS: The proposed method outperforms standard mutual information of intensity only. The segmentation errors had been significantly reduced at the left ventricle myocardium and the right atrium. The mean surface distance of using our framework is around 1.73 mm for the whole heart.

Measurements of Coronary Artery Aneurysms Due to Kawasaki Disease by Dual-Source Computed Tomography (DSCT).

Diameters of coronary artery aneurysms (CAAs) complicating acute phase KD can strongly predict the long-term prognosis of coronary artery lesions (CAL). Recently, computed tomographic angiography (CTA) has been used to detect CAL, and the purpose of this study was to determine whether coronary artery diameters measurements by CTA using dual-source computed tomography (DSCT) can be used instead of coronary angiogram (CAG) measurements. Twenty-five patients (22 males and three females) with CAL due to KD, who had undergone both CTA and CAG within one year, were retrospectively evaluated between 2007 and 2013. A prospective electrocardiogram-triggered CTA was performed on a DSCT (SOMATOM(®) Definition, Siemens Healthcare, Germany). Two pediatric cardiologists independently measured the diameters of CAAs twice in each maximum intensity projection (MIP), curved multiplaner reconstruction (MPR) and CAG. We measured 161 segments in total (segment 1-3, 5-7, 11, 13). Diagnostic accuracy was expressed as κ coefficient. A Bland-Altman analysis was also used to assess the intra-observer, inter-observer and inter-modality agreement. The diagnostic quality of CTA was excellent (κ = 0.93). Excellent inter-observer agreement for the diameters of CAAs was obtained for MIP, MPR and CAG and for the intra-observer agreement. The inter-modality agreement was also excellent in measurements of CAA (MPR-CAG: y = 0.9x + 0.40, r = 0.97, p < 0.0001 MIP-CAG: y = x + 0.1, r = 0.94, p < 0.0001). These values in normal coronary arteries were also obtained. We found a significant correlation between CTA and CAG in measuring the coronary arteries. We conclude that measuring coronary artery diameters by CTA is reliable and useful.

Principle of 64-Slice Dual-Source Computed Tomography / 医疗卫生装备

The construction of 64-slice-dual-source computed tomography(DSCT) is introduced.Its imaging principle and clinical application are put forward.DSCT has special advantages in diagnosing coronary stricture.The principles of DSCT and energy subtraction imaging are expatiated in detail.DSCT has great value in clinical research and application.